Low libido in women is often blamed on stress, aging, or relationship problems, but changes in desire may begin years before menopause and can involve hormones, medications, pain, sleep, blood flow, and the difference between spontaneous and responsive desire.
Dr. Natalie Crawford sits down with board-certified urologist Dr. Kelly Casperson, author of “You Are Not Broken” and “The Menopause Moment,” to explain why women may stop wanting sex, how testosterone and estrogen affect sexual health, and what to discuss with a clinician when something feels different. They also examine birth control and SSRI side effects, hormone therapy, vaginal estrogen, and why women’s sexual health deserves greater attention.
IN THIS EPISODE:
00:00 Why Women Can Lose Desire Before Menopause
02:10 Can Your Hormones Change While You Still Have a Period?
03:38 Why Testosterone Matters in Women
05:41 Can Birth Control Lower Your Libido?
08:04 How Estrogen Affects Desire, Arousal, and Vaginal Health
10:02 What Does Low Libido Actually Mean?
10:56 When Low Libido Is Really Painful Sex
13:15 Spontaneous vs. Responsive Desire
15:25 Are You Having Sex Worth Desiring?
16:53 What Causes Arousal Problems in Women?
17:20 How SSRIs Can Affect Sexual Function
17:50 How Couples Can Navigate Mismatched Sex Drives
21:05 Why Perimenopause Can Make You Feel Unlike Yourself
21:24 How Sleep, Estrogen, and Progesterone Affect Desire
21:50 Testosterone’s Role in the Brain, Mood, and Motivation
24:40 How Is Testosterone Prescribed to Women?
27:15 What Happens When Testosterone Is Too High?
30:30 Can Testosterone Affect More Than Libido?
32:00 Testosterone, Wound Healing, and Bone Health
33:25 Could Testosterone Support Hip-Fracture Recovery?
34:00 Can Hormone Therapy Still Help Women Over 60?
36:00 Systemic vs. Vaginal Estrogen
37:00 Why Hormone Treatment May Begin Before Menopause
39:55 Can You Get Pregnant During Perimenopause?
41:41 When Vaginal Estrogen May Help
46:12 How to Talk to Your Doctor About Hormones
48:25 Where to Find Dr. Kelly Casperson
GUEST RESOURCES:Website: https://kellycaspersonmd.comInstagram: https://www.instagram.com/kellycaspersonmdPodcast: https://kellycaspersonmd.com/you-are-not-broken-podcastYou Are Not Broken: https://kellycaspersonmd.com/you-are-not-broken-bookThe Menopause Moment: https://kellycaspersonmd.com/the-menopause-moment-book
AS A WOMAN WITH DR. NATALIE CRAWFORD:
YouTube: https://youtube.com/playlist?list=PLveZDgg3_HZ9m7Wy3C6Vvyrj_NtEOwj_l
Apple Podcasts: https://podcasts.apple.com/us/podcast/as-a-woman/id1449553339
Spotify: https://open.spotify.com/show/12IYOLH9liu60gk5D0bRPk
HOST RESOURCES:
Order The Fertility Formula: https://www.nataliecrawfordmd.com/book
Newsletter: https://www.nataliecrawfordmd.com/newsletter
Instagram: https://www.instagram.com/nataliecrawfordmd
YouTube: https://www.youtube.com/@NatalieCrawfordMD
Become a patient: https://www.forafertility.com
Earn FREE CE/CME: https://learnatpinnacle.com/education
This episode is brought to you by The Pinnacle Podcast Network.
ABOUT DR. NATALIE CRAWFORD:
Natalie Crawford, MD, is a double board-certified OB/GYN and reproductive endocrinologist, co-founder of Fora Fertility, and author of The Fertility Formula. She helps women understand their hormones, fertility, and reproductive health so they can make informed decisions about their bodies.
Disclaimer: Natalie Crawford, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care.
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